Magic Show Registration

Tuesday, April 30, 2013 from 6:30 - 8PM

Please complete a separate registration form for each child.

Child's Full Name(*)

Please enter your child's name.

Child's Age(*)

Please enter your child's age.

Parent / Legal Guardian's Name(*)

Please enter the parent's name.

Parent/Legal Guardian's Library Card Number(*)

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(Not a registered patron? You must bring your Driver’s License and proof of address to the library and register for a library card before registering for Story Time. If your library card is expired or you owe money to the library, you will not be permitted to register for Story Time until the library card is renewed and all charges are paid.)

Phone Number(*)

Please enter the best phone number to reach you.

Email Address

Please enter your email address.

Street Address(*)

Please enter your street address.

City(*)

Please enter your city.

Municipality of Residence(*)

Upper Saucon Township

Coopersburg Borough

Lower Milford Township

Other

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Please check the box if you agree to the following Photo Release Statement:

I grant to Southern Lehigh Public Library (SLPL), the right to take photographs of me and my family in connection with the above identified event. I agree that SLPL may use such photographs of me,without my name, for such purposes as publicity, illustration, advertising and web content.

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Magic Show Registration

Please complete a separate registration form for each child.

Note: Registration confirmation will not be sent if email address is not provided. Please allow up to 72 hours for confirmation email.

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